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11 Flashcards

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1
Q

what is blood in terms of tissue

A

Specialist connnective tissue

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2
Q

what are the major constituents of blood

A

plasma and cells

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3
Q

what percentage of total extracellular fluid does plasma make up

A

20%

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4
Q

what is plasma made up of (percentages)

A

Water (90%)​
Solvent, lubricant, cushion, heat dissipator​

Glucose, salts and other dissolved chemicals (2%)​

Protein (8%)​
Albumin (60%) (transport and oncotic pressure prevents fluid from leaking)​
Globulin (36%) (immune)​
Fibrinogen (4%) (blood haemostasis)

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5
Q

what ions are found in plasma

A

Inorganic ions (potassium, sodium, calcium, chloride, bicarbonate, phosphate)​

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6
Q

what is the function of ions in plasma

A

electrolyte balance

(maintain BP and support heart and muscle contraction​)

dissolved carbon dioxide as carbonic acid, hydrogen and bicarbonate ions or bound to amino groups of proteins – including haemoglobin (maintenance of pH)​

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7
Q

what does blood pH depends on

A

on the ratio of CO2 / HCO3-

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8
Q

where does excess H plus ions in the blood come from and what do they cause

A

metabolic process and metabolic waste

cam cause acidosis

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9
Q

what can blood acting as a buffer prevent

A

acidosis

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10
Q

whats another name for WBC

A

leucocytes

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11
Q

what cells make up the blood

A

RBC
WBC
Platelets

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12
Q

where is blood made

A

bone marrow

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13
Q

where can bone marrow be extracted from

A

pelvis bone

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14
Q

whats hematopoesis

A

The production of all of the cellular components of blood and blood plasma

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15
Q

lifespan of RBC

A

120 days

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16
Q

what hormone stimulates the production of RBC

A

EPO

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17
Q

what happens to alpha and beta subunits when oxygen binds

A

it changes conformation

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18
Q

what molecules promote O2 release in tissues

A

H+ , CO2 and 2,3 DPG

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19
Q

what is anaemia

A

Low hemoglobin concentration

NOT a DIAGNOSIS its underlying a cause

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20
Q

whats the commonest blood disorder

A

anemia 25%

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21
Q

what is the guideline for defining male and female anamia

A

Hb<130g/L for males

Hb<115 females​

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22
Q

what’s the cause of anaemia

A 
Decreased production: Haematinic deficiency​
Anaemia of chronic disease​
Medications ​
Infiltration​
Aplasia

or increased loss​ of blood:
Bleeding​
Haemolysis

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23
Q

how does the body try to compensate for anaemia

A

Anemia: reduced oxygens supply to kidneys –> increased EPO and increased RBC production by BM but it takes a long time to put Hb back up again.

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24
Q

what are some symptoms of anaemia

A

Tiredness​
Faint​
Shortness of breath​
Worsening of heart related pain (angina)​
Rapid heart beat (experienced as palpitations)

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25
what are some signs of anaemia
``` Pale​ Rapid heart beat (tachycardia)​ Bounding pulse​ Systolic flow murmur​ Cardiac failure​ Retinal haemorrhages ```
26
What are the three types of anaemia and whats the main difference between them
microcytic <80 fL Normocytic 80-100 fL Macrocytic >100 fL They differ in Mean Cell Volume
27
what causes Microcytic Anemia
Iron deficiency​ | Thalassaemia​
28
what causes Normocytic Anemia
``` Acute blood loss​ Anaemia of chronic disease ​ (e.g. infections, malignancy)​ Renal failure​ Leukaemia​ Sickle cell anaemia ```
29
what causes Marcocytic Anemia
B12/folate deficiency ​ (megaloblastic anaemia)​ Alcohol​ Liver disease
30
what type of anaemia represents the most cases
99% microcytic
31
B12 and folate uses
to make cells
32
how can you determine wether anaemia is caused by increased destruction or reduced production
reticulocyte count
33
what does a low reticulocyte count indicate in terms of bone marrow efficacy
BM is not fine
34
what does a high reticulocyte count indicate in terms of bone marrow efficacy
BM is fine
35
what causes iron deficiency anaemia
Menstrual loss (young females)​ Infection (hookworm) leads to gut bleeding​ Growth spurt, pregnancy ​ Gastrointestinal loss: ​ Bleeding ulcers, inflammatory bowel disease, CANCER
36
what are platelets
``` Small circulating cells (2 - 3 ul)​ without a nucleus​ Fragments of megakaryocytes ​ from bone marrow​ 1 million/second​ 10 day lifespan​ Involved in coagulation​ Platelet plug​ Coagulation cascade​ ​ ```
37
what pathology is characterised by low platelet levels
thrombocytopenia which can cause bleeding and bruising
38
what are neutrophil
``` About twice as big as red cell​ 2 -4 lobes, fine granules​ Normally the most common white cell - levels very dynamic​ Half-life 6-8 hours​ 1011/day=1 million/second​ ​ ```
39
whats neutrophilia
Increase in number of neutrophils
40
whats neutropneia
decrease in number of neutrophils
41
what causes neutrphilia
Infection​ Inflammation​ Tissue damage​ Haemorrhage
42
what causes neutropneia
``` Overwhelming sepsis (blood poisoning)​ HIV​ Bone marrow failure (no blood cells produced) – aplastic anaemia, leukaemia​ Medications​ B12/folate deficiency ```
43
what are eosinophils
``` Bilobed nucleus​ Bright orange granules​ Increase in​ Parasitic (worm) diseases​ Skin disorders​ Asthma​ ```
44
what are basophils
2 - 3 lobed nucleus​ Large blue granules containing histamine​ Variety of causes of increased levels​
45
what are monocytes
Large with kidney shaped nucleus​ Similar function to myeloid cells, turn into macrophages​ Also important in immune system – presents foreign substance (antigen) to lymphocytes​ Increased in chronic infections and viral infections​
46
what are lymphocytes
``` Small and dense with little cytoplasm. Few granules​ T cells: Coordinate immune responses​ B cells: produce antibody​ NK cells: viral and tumour immunity​ Increased in viral infections​ Lifespan: 1 week-100 years​ ```
47
whats the result of bone marrow failure
Anaemia, thrombocytopenia, leucopenia​ Fatigue, bleeding, infections, DEATH​ ``` caused by Leukaemia and other haematological cancers​ Aplastic anaemia​ Chemotherapy, toxins, radiation​ B12/folate deficiency​ ```
48
how do we detect haematological problems
blood count | blood films
49
RBC
absolute number x 10^12/L
50
Mean cell volume
average size in fl
51
hemoglobin
​Amount in whole blood in g/dL​ Mean cell haemoglobin (MCH) - aberage amount of Hb in a red cell (in png)​ Reduced if cells are small​ - mean cell haemoglobin concnetratiobn (MCHC( - concentration of hemoglobin in a red cell – in %​ Reduced if hemoblobin in cel is low
52
what are cell/plasma components
Cell/plasma components​ Hematocrit (Hct) or packed cell volume (PCV) - ratio of packed cells​ ​ Platelets​ Platelet count – absolute number x 10^9/L​ ​ WBC​ White cell count (WCC or WBC) absolute number x 10^9/L​ White cell differential (different tupes of cells seens​ Absolute number/L​ % of total white cells (neutrophils, lymphocytes...)​
53
blood films
Spread on glass​ Fixed with alcohol, stained with May-grunwald giemsa​ Used to examine morphology of cells​ Bone marrow biopsy may be considered​
54
other blood tests
``` Coagulation tests​ Prothrombin time and APTT​ Fibrinogen, clotting factor tests, vWF​ ​ Ferritin, iron/trasnferrin/ITBC/iron saturations​ Vitamin B12 and folate​ Immunoglobulins and serum free light chains​ Serum EPO​ Specialist hematology cancer diagnosits​ ```
55
what percentage of blood does plasma make up
55%
56
in blood, everything that makes up the blood other than plasma is called
formed elements (includes WBC, platelets)
57
what causes High reticulocyte count
bleeding | hemolysis
58
what causes low reticulocyte count
``` Haematinic deficiency​ Anaemia of chronic disease​ Medications ​ Infiltration​ Aplasia ```
59
which cells are granulocytes
neutrophil eosinophils basophil lymphocytes
60
what are lymphocytes
T cell B cell NK cells
61
Most blood cancers are from ​
wbc

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